Ingaba ivalvu yentliziyo yakho iyavuza kancinci? Masifunde ngeMitral Valve Regurgitation!

Ngaba ngamanye amaxesha ukhe ufumane kunzima ukuphefumla ngequbuliso? Okanye uziva into engaqhelekanga, enzima esifubeni sakho? Ngaba ngamanye amaxesha uziva udiniwe nasemva kokwenza imisebenzi emincinci? Esinye sezizathu zezinto ezinjalo sinokuba yingxaki yomnyango omncinci entliziyweni yakho, oko kukuthi, ivalvu. Namhlanje siza kuthetha ngeMitral Valve Regurgitation, imeko enjalo. Ungakhathazeki, masiyiqonde ngokulula le nto.

Yintoni le valve ye-mitral esentliziyweni? Kwenzeka ntoni xa ingasebenzi kakuhle?

Ngamafutshane, ivalvu ye-mitral ngumnyango ophakathi kwegumbi eliphezulu (i-atrium yasekhohlo) kunye negumbi elisezantsi (i-ventricle yasekhohlo) kwicala lasekhohlo lentliziyo yakho. Yicinge njengomnyango endlwini yakho. Lo mnyango kufuneka uvuleke kwaye uvale kakuhle, uvumele igazi ukuba liphume kwigumbi eliphezulu liye kwigumbi elingaphantsi. Emva koko, lo mnyango kufuneka uvalwe ngokufanelekileyo ukuze uthumele igazi ukusuka kwigumbi elingaphantsi liye kuwo wonke umzimba wakho. Ngaphandle koko, igazi liya kuqala ukuvuza kwakhona kwigumbi eliphezulu.

Kodwa ngamanye amaxesha olu cango aluvaleki kakuhle. Njengokuba iingcango ezindlwini zethu ngamanye amaxesha zingavaleki kakuhle, nto leyo eshiya indawo encinci. Oku kusenokubangelwa yingxaki yocango ngokwalo, oko kukuthi, izicubu zevalvu. Okanye kunokubangela ingxaki yodonga olujikeleze ucango, oko kukuthi, amagumbi asekhohlo entliziyo. Nangona kunjalo, xa olu cango lungavaleki kakuhle, igazi elithile livuza ngasemva, oko kukuthi, kwigumbi eliphezulu. Oku kubizwa ngokuba yi -mitral valve regurgitation okanye ``Mitral Regurgitation - MR''.

Cinga ngayo njengempompo yamanzi. Ukuba impompo ayivalwanga kakuhle, amanzi aya kuvuza, akunjalo? Kunjalo ke ngale.

Ukuba oku kuvuza kuncinci, oko kuthetha ukuba indawo esecangweni incinci kakhulu, kusenokungabi yingxaki enkulu. Intliziyo yakho inokuyinyamezela, ngoko usenokungaziva mahluko. Nangona kunjalo, ukuba oku kuvuza kukhulu, oko kuthetha ukuba ucango luvulekile, intliziyo yakho iziva ixinezelekile kakhulu. Kuba intliziyo kufuneka isebenze nzima kunesiqhelo ukupompa inani legazi elifunekayo ukuze ipompe phambili. Ekuhambeni kwexesha, intliziyo ayisakwazi ukuyinyamezela le nto, kwaye unokufumana iimpawu kunye nezinye iingxaki.

Le meko ikwabizwa ngokuba:

• Ukungasebenzi kakuhle kwevalvu yeMitral (`(Ukungasebenzi kakuhle kwevalvu yeMitral)`)
• Ukungakwazi ukusebenza kakuhle kwevalvu ye-mitral
• Ivalvu ye-mitral evuzayo (`(ivalvu ye-mitral evuzayo)`)

Enyanisweni, i-mitral valve prolapse lolona hlobo luqhelekileyo lwesifo se-valve yentliziyo kumazwe afana ne-United States. Ixhaphake kakhulu kubantu abadala, ingakumbi abo baneminyaka engaphezu kwama-65 ubudala.

Ngaba kukho naziphi na iintlobo zokuvuza kwevalvu ye-mitral?

Ewe, kukho iintlobo ezimbini eziphambili:

1. Ukubuyela kwesisu okuphambili (`(Ukubuyela kwesisu okuphambili)`): Kule meko, ingxaki ikuyo ivalvu ngokwayo. Ibangelwa kukonakala kwesakhiwo kwenye okanye ngaphezulu kwenxalenye yevalvu okuthintela ukuba ingavaleki kakuhle. Umzekelo, amaphecana evalvu anokuba bhetyebhetye kakhulu aze angavaleki kakuhle, okanye anokuba makhulu aze angavaleki kakuhle.

2. Ukubuyela kwe-mitral yesibini : Oku kubangelwa yenye imeko yentliziyo echaphazela amagumbi entliziyo (i-atrium yasekhohlo okanye i-ventricle) exhasa ivalvu. Umzekelo, isifo semisipha yentliziyo (i-cardiomyopathy) sinokubangela ukuba intliziyo ikhule kwaye ibe buthathaka. Olu tshintsho lunokubangela ukuba ivalvu ijikeleze kwaye ingavali kakuhle.

Nokuba loluphi uhlobo lokuvuza, lunokuba yingozi ngequbuliso (`(Acute)`), okanye lunokukhula kancinci kancinci ngokuhamba kwexesha (`(Chronic)`).

Ziziphi iimpawu ezinokubakho xa kukho ukuvuza kwivalvu ye-mitral?

Ukuba ukuvuza kuncinci, usenokungabi nazimpawu. Kodwa xa ukuvuza kukhulu kwaye kuqala ukuchaphazela ukusebenza kwentliziyo, uphawu oluqhelekileyo kukuphefumla kancinci (ukuphelelwa ngamandla) . Usenokuziva ngathi awukwazi ukufumana umoya owaneleyo emiphungeni yakho, okanye unokuziva uphelelwa ngumoya xa umile nje, ulele phantsi, uzama ukulala, okanye usenza imisebenzi elula.

Kusenokubakho nezinye iimpawu:

• Intlungu yesifuba engaqhelekanga.
• Ukukhwehlela.
• Ukudumba kwemilenze okanye iinyawo (`(Edema)`).
• Ndiziva ndidiniwe kakhulu (`(Ukudinwa)`).
• Kuvakala ngathi kukuquleka, kodwa akwenzeki ngokwenene (`(Presyncope)`).
• Ukuziva ngathi isantya sentliziyo yakho siyatshintsha, njengesifuba sakho siyabetha ngamandla (`(Intliziyo ibetha ngamandla)`).

Ezi mpawu zinokuvela kancinci kancinci okanye ziqale ngequbuliso.

Le yimeko engxamisekileyo! Ukuba ufumana ezi mpawu, yiya esibhedlele ngokukhawuleza!

Ukuba intliziyo yakho isebenza nzima kakhulu, unokuba neempawu zokusilela kwentliziyo ngokukhawuleza. Ezi zinokuvela ngequbuliso, ngoko ke lumka ezi mpawu:

• Ukuphefumla kakhulu.
• Ndiziva ngathi uyafuthanisela.
• Ubunzima bokuphefumla xa ulele phantsi.
• Ukuziva uxinene esifubeni.
• Ukuba i-pulse oximeter ekhaya ibonisa ukuba inqanaba le-oksijini egazini liphantsi.

Ukusilela kwentliziyo ngokukhawuleza yimeko engxamisekileyo yezonyango apho intliziyo iyeka ukusebenza ngequbuliso kwaye inokuba yingozi ebomini. Ke ngoko, kubalulekile ukufuna unyango ngokukhawuleza.

Kutheni le valve ye-mitral ingavaleki kakuhle? Zithini izizathu?

Njengoko besikhe sathetha ngaphambili, le ngxaki yenzeka xa ivalvu ye-mitral ingavalwanga kakuhle. Le valve ineeflaps ezimbini (amaphecana). Ziyavuleka zize zivale ukuvumela igazi ukuba liphume kwigumbi eliphezulu liye kwigumbi elisezantsi.

Ukuba la maphetshana okanye ezinye iindawo zevalvu zonakele, okanye ukuba izifo ezahlukeneyo zibangela ukuba ivalvu ingavaleki kakuhle, igazi elincinci livuza umva rhoqo xa ivalvu ivala.

Izizathu zoku ziyahluka ngokuxhomekeke kuhlobo lwe-MR onalo (oluphambili okanye olwesibini).

Ukubuyela kwevalvu ye-mitral yokuqala kunokubangelwa zezi zinto zilandelayo:

• I-Mitral valve prolapse (MVP) : Le yeyona nto ixhaphakileyo kumazwe aphuhlileyo.
• Isifo sentliziyo esibizwa ngokuba yi-rheumatic heart disease : Esi sesona sizathu siphambili kwihlabathi liphela.
• Izifo zezicubu ezidityanisiweyo (`(Izifo zezicubu ezidityanisiweyo)`).
• Isiphene sentliziyo esizalwa naso esibizwa ngokuba yi-``(Cleft mitral valve)``.
• Usulelo lwengaphakathi lentliziyo (endocarditis).
• Isifo sentliziyo esibangelwa lunyango lwemitha (`(Isifo sentliziyo semitha)`).
• Ukwenzakala ngengozi.

Ukubuyela kwevalvu ye-mitral yesibini kunokubangelwa zezi zinto zilandelayo:

• I-Ischemic cardiomyopathy (le yeyona ixhaphakileyo) ibangelwa kukuvaleka kwemithambo yegazi ehambisa igazi entliziyweni.
• I-Atrial fibrillation, ukubetha kwentliziyo okungaqhelekanga.
• I-cardiomyopathy edibeneyo (isifo semisipha yentliziyo esibangela ukuba intliziyo ikhule ngaphandle kwesizathu esaziwayo)
• Isifo esibangelwa kukutyeba kwemisipha yentliziyo (`(Hypertrophic obstructive cardiomyopathy)`).

Zeziphi iingxaki ezinokwenzeka ukuba le meko iba mandundu?

Ukuba ayinyangwa, i-mitral valve prolapse inokuba yingozi ebomini. Nazi ezinye zeengxaki ezinokubakho:

• Intliziyo yakho iqala ukubetha ngendlela engaqhelekanga (`(Atrial fibrillation)`), nto leyo ngamanye amaxesha enokukhokelela kwistroke.
• Intliziyo yakho ayikwazi ukupompa igazi elaneleyo emzimbeni (`(Ukusilela kwentliziyo)`).
• Uxinzelelo olukwimithambo yegazi ethwala igazi ukusuka entliziyweni ukuya emiphungeni luyanda (`(Uxinzelelo lwegazi oluphezulu lwemiphunga)`).
• Intliziyo ingayeka ukubetha ngequbuliso (`(Ukuma kwentliziyo ngequbuliso)`).

Ugqirha uluchonga njani ngokuchanekileyo olu sifo?

Into yokuqala eyenziwa ngugqirha kukuxilonga kakuhle.

• Bakubuza ngeempawu zakho kunye nezinye izifo onazo.
• Baza kujonga iimpawu zakho ezibalulekileyo, ezinje ngoxinzelelo lwegazi kunye nesantya sokubetha kwentliziyo.
• Bayawujonga umzimba ukuba awudumbanga na (ukudumba).
• I-stethoscope iya kumamela intliziyo yakho kunye nemiphunga. Ukuba uva isandi sentliziyo esingaqhelekanga ("ukugquma kwentliziyo"), oko kungaba luphawu lwesifo sevalvu.

Emva koko ugqirha uya kuyalela iimvavanyo ezininzi ukuze afumane ulwazi oluthe kratya.

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe esi sifo?

Oogqirha badla ngokwenza uvavanyo olubizwa ngokuba yi-transthoracic echocardiogram (TTE) ukuze bajonge ukuvuza kwivalvu yakho ye-mitral. Olu luvavanyo olungenabuhlungu, olungangenisi ntlungu. Lunokujonga ukuvuza kwivalvu yakho kunye nezinye iingxaki malunga nolwakhiwo okanye ukusebenza kwentliziyo yakho. Ukuba ugqirha wakho ufuna ukujonga ivalvu yakho kufutshane, banokwenza uvavanyo olubizwa ngokuba yi-transesophageal echocardiogram (TEE).

Ugqirha wakho unokuyalela iimvavanyo ezongezelelweyo ukuze abone ukuba imeko yakho imbi kangakanani aze acwangcise unyango. Ezi ziquka:

• I-`(CT scan)` yentliziyo (`(Cardiac CT scan - computed tomography scan)`).
• I-`(Echocardiogram)` eyenziwa ngexesha lokuzilolonga (`(Exercise stress stress echocardiogram)`).
• Uvavanyo lwe-MRI yentliziyo (magnetic resonance imaging).
• Ukuhlolwa kwentliziyo nge-catheterization, okwaziwa ngokuba yi-cardiac cath okanye i-coronary angiogram.

Ziziphi iindlela zonyango zokuvuza kwevalvu ye-mitral?

Akukho nto ibizwa ngokuba lunyango "oluhambelanayo nolunye". Oogqirha baza kulungelelanisa unyango ngokweemfuno zakho. Baza kuqwalasela oku kulandelayo:

• Uhlobo lokubuyela kwesisu (oluphambili okanye olwesibini).
• Ubunzima bemeko yakho. Ingachazwa njengesigaba A, B, C, D. UD lelona nqanaba linzima kakhulu.
• Umngcipheko weengxaki ezivela kutyando.

Ugqirha wakho uza kukuchazela iindlela zonyango lwakho, kuquka izinto ezilungileyo nezingalunganga. Qiniseka ukuba ubuza imibuzo ukuba kukho into ongayiqondiyo. Ngale ndlela, ungenza isigqibo esinolwazi.

Ukubuyela kwe-mitral kwi-valve yentliziyo sesona sizathu sesibini esiqhelekileyo sotyando lweevalve zentliziyo kumazwe aseNtshona (esokuqala yi-aortic valve stenosis).

Kukho iindlela ezahlukeneyo zonyango:

Ukulungiswa kwevalvu yeMitral (`(ukulungiswa kwevalvu yeMitral)`)

Iinketho zoku:

• Utyando lwentliziyo evulekileyo.
• Utyando lwentliziyo olusebenzisa imingxunya emincinci (`(Utyando lwentliziyo olungena kakhulu)`).
• Ukulungiswa kweMitral transcatheter edge-to-edge (TEER): Kule nkqubo, ugqirha usebenzisa ityhubhu ende, ebhityileyo (catheter) ukuncamathisela ikliphu encinci kwiincwadana zakho zevalvu. Le kliphu inceda iincwadana zivale kakuhle.

Ukutshintshwa kwevalvu yeMitral (`(Ukutshintshwa kwevalvu yeMitral)`)

Iinketho zoku:

• Uza kunikwa utyando lwentliziyo evulekileyo (`(utyando lwentliziyo evulekileyo)`) kwaye kuza kufakwa ivalvu entsha ye-mitral. Le valve ingenziwa ngesinyithi (`(mechanical)`) okanye yenziwe ngezicubu zezilwanyana (`(bioprosthetic)`).
• Ukutshintshwa kwevalvu ye-transcatheter mitral (TMVR) yinkqubo engaphantsi kakhulu.

Unyango lokusilela kwentliziyo

Oku kungabandakanya:

• Amayeza afana ne -diuretics .
• Ukufakelwa kwesixhobo sokuncedisa i-ventricular yasekhohlo (LVAD).
• Ukhathalelo lwentlungu.

Unyango lwe-atrial fibrillation

Oku kungabandakanya:

• Amayeza.
• Iinkqubo.
• Utyando.

Impilo yam iza kuba njani xa ndifumana esi sifo?

Zininzi izinto ezichaphazela indlela impilo yakho eya kuba yiyo. Umzekelo:

• iminyaka yakho.
• Ngaba unazo iimpawu kwaye zinzima kangakanani?
• Ubukhali bokuvuza.
• Ngaba ivalvu yakho ingalungiswa?
• Ubungakanani bomonakalo entliziyweni yakho.

Ngenxa yokuba zonke ezi zinto zichaphazela imeko yakho, imeko yakho inokwahluka kweyabanye. Ugqirha wakho ngumntu ongcono ukwazi ngqo indlela imeko yakho eza kuqhubeka ngayo. Uyakwazi wena, imbali yakho yezonyango, kunye neendlela zonyango ezinokukunceda.

Ikhawuleza kangakanani le mitral valve leak?

Kwabanye abantu, oku kuhamba kancinci. Kwabanye, kunokuhamba ngokukhawuleza. Ugqirha wakho uza kukuxelela ukuba imeko yakho injani, kufuneka uye kangaphi kugqirha ukuze ahlolwe, kunye nendlela le meko enokuchaphazela ngayo ubomi bakho.

Ngaba kukho iindlela zokuthintela esi sifo?

Usenokungakwazi rhoqo ukuthintela oku. Nangona kunjalo, ungasebenzisana nogqirha wakho ukunciphisa umngcipheko wakho wokufumana izifo ezahlukeneyo zentliziyo. Ugqirha wakho uza kujonga imbali yakho yezonyango kunye nezinto ezinobungozi aze akunike iingcebiso ezifanelekileyo kuwe. Ngokubanzi, ungenza oku kulandelayo:

• Yeka ngokupheleleyo ukusebenzisa iimveliso zecuba (ezifana neecuba, ii-beedis).
• Zilolonge rhoqo.
• Yitya ukutya okunempilo okunempilo entliziyweni.
• Gcina ubunzima bakho busempilweni.
• Bona ugqirha ubuncinane kanye ngonyaka ukuze uhlolwe kwaye ufumanise naziphi na iingxaki ngokukhawuleza.
• Ukuba uhlala unesihlungu somqala kunye nomkhuhlane, okanye ukuba ukhe waba nomkhuhlane wamathambo ngaphambili, bona ugqirha.

Ndingazinyamekela njani?

Kusoloko kulungile ukulawula uxinzelelo lwakho lwegazi nokutya iziqhamo nemifuno emininzi .

Ukuba yinxalenye yenkqubo yokuvuselela intliziyo (`(Cardiac rehab)`) emva kotyando lwevalvu yentliziyo kunokukunceda uqalise ukuzilolonga kwakhona.

Ukuba unevalvu entsha yokufakelwa, kuya kufuneka uthathe amayeza emva koko. Kuya kufuneka uthathe amayeza okuthintela ukuqhekeka kwegazi (izinto ezinciphisa igazi) ubomi bakho bonke ukuze uthintele ukuqhekeka kwegazi. Kuya kufuneka uthathe amayeza okubulala iintsholongwane ukuthintela i-endocarditis (usulelo lwengaphakathi lentliziyo) ngaphambi kotyando lwamazinyo kunye novavanyo oluthile lokuphefumla oluphezulu.

Ndifanele ndimbone nini ugqirha? Zeziphi imibuzo endifanele ndizibuze zona?

Ugqirha wakho uza kukuxelela ukuba kufuneka ubonane nogqirha wakho kangaphi ukuze ahlolwe. Okukhona imeko yakho inzima, kokukhona kufuneka ubonane nogqirha wakho rhoqo kwaye wenze iimvavanyo zomfanekiso (ezifana neeskeni). Kubalulekile ukugcina onke amadinga akho.Ugqirha unokujonga imeko yakho aze akucebise ngonyango ngexesha elifanelekileyo.

Nantsi eminye imibuzo onokuyibuza ugqirha wakho ukuze afunde ngakumbi ngemeko yakho:

• Ingakanani i-mitral valve evuzayo?
• Zeziphi iindlela zonyango ondicebisa zona?
• Ziziphi iingenelo kunye neengxaki zonyango?
• Zeziphi iinguqu zendlela yokuphila ekufuneka ndizenze?
• Kufuneka ndidibane nogqirha okanye ndivavanywe imifanekiso kangaphi?
• Impilo yam yexesha elizayo iza kuba njani?

Into omawucinge ngayo

Kuqhelekile ukuziva uxinezelekile xa usiva ukuba unesifo sentliziyo. Kodwa njengoko ufunda ngakumbi ngemeko yakho kwaye ufumana unyango, uya kukwazi ukuqhubela phambili kwakhona kungekudala.

I-Mitral valve prolapse ichaphazela wonke umntu ngokwahlukileyo, ngoko ke ugqirha wakho uya kulungelelanisa unyango lwakho ngokweemfuno zakho. Musa ukuthandabuza ukwabelana ngemibuzo yakho kunye neenkxalabo zakho nogqirha wakho. Uya kukunceda uqonde ngakumbi malunga nendlela intliziyo yakho esebenza ngayo. Uya kucebisa nonyango kunye notshintsho kwindlela yokuphila oluya kukunceda uhlale usempilweni kwaye uphile ubomi obusemgangathweni.

Ivalvu yeMitral , isifo sevalvu yentliziyo, ukuphefumla okufutshane, uhlaselo lwentliziyo, utyando lwentliziyo, i-echocardiogram, ukuhlaziywa kwevalvu ye-mitral